National Workshop on Ksharasutra

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Given the safety, cost-effectiveness and the success rate of Ksharasutra in the treatment of anal fistula, the Department of AYUSH, in collaboration with the ICMR and the CCRAS, is organizing a National Campaign to promote the use of Ksharasutra in ano-rectal diseases. A National Workshop is being organized on 24-25 August 2007 in the auditorium of the All India Institute of Medical Sciences, New Delhi. Eminent experts in Ksharasutra will be participating in the Workshop. In keeping with the increased interest in Ksharasutra in foreign countries, a renowned Japanese expert Dr. Kenji Tazawa will also be participating in the National Workshop.

Even though there has been a resurgence of interest in Ayurveda in India and abroad on account its proven promotive, preventive and curative aspects, one its major branches – Ayurvedic surgery- has not got much publicity. This is a bit strange considering that Ayurvedic surgery has a long and hoary tradition stretching from Susruta who lived around 1500-1000 BC.

There is one particular Ayurvedic surgical procedure described by Susruta which has been developed and standardized by Ayurvedic researchers and scientifically validated by modern medicine in the 20th century which is providing relief to large numbers of patients of Anal fistula, also known as Bhagandara in Ayurveda. The Ksharasutra procedure is a minimally invasive surgical procedure for the treatment of Anal fistula, a painful condition affecting large numbers of people which is conventionally treated by surgery. Surgery for Anal fistula requires hospitalization and postoperative care, all of which is costly, and there is probability of damage to the tissues around the anal canal. The incidence of recurrence after conventional surgery is also rather high. In comparison, Ksharasutra has much lower recurrence rate and, more importantly, is an ambulatory form of treatment and hospitalization with its attendant expenditure and loss of income is not involved. Ksharasutra is safe and can be used on patients who would otherwise be considered a high risk in conventional surgery. The cost to the patient for the procedure is also quite low.

The Ksharasutra or medicated thread is prepared by repeatedly coating a surgical linen thread with an alkali of the Achyranthes aspera plant, latex of Euphorbia nerifolia and turmeric powder. The coated medicated thread has proteolytic, caustic and antiseptic properties and promotes rapid wound healing. In the Ksharasutra procedure the medicated thread is inserted through the external opening of the fistula and ligated through the anal opening. The procedure is done in an operation theatre under local anesthesia and the patient is able to leave the hospital after 10-15 minutes. The Kshara coated on the thread cuts the fibre tissue in 2-3 days and the healing of the tract occurs within 3-4 days. The thread is replaced after 7 days.  The normal cutting time is 1 cm. per week. This means that if the fistula is 5 cm. long the treatment will take 5 sittings.   The Ksharasutra therapy is unique in that it provides for cutting and healing simultaneously.

Though there are references to Ksharasutra in the Ayurvedic classics, no detailed description of the preparation of the Ksharasutra and the method of application is available.  In 1964, Ksharasutra therapy was developed by the late Dr. P.S. Shankaran in the Department of Shalya Shalaka of the Banaras Hindu University. Subsequently, a great deal of significant clinical and research work was done under the guidance of Prof. P.J. Deshpande in the Department of Shalya Shalaka. More than 15 different types of Ksharasutra were evaluated and techniques for the preparation of the Ksharasutra, the designing of instruments required for its application were developed and standardized by the Department of Shalya Shalaka. The Department also set up an Ano-rectal clinic where more than 20,000 patients have been treated with a success rate of 97 per cent.

The Indian Council of Medical Research (ICMR) conducted randomized, double blind, multi-centric clinical trials on Ksharasutra therapy and it was found that the recurrence of anal fistula was only 4 per cent as compared to the 11 per cent in patients who had undergone conventional surgery.  Ksharasutra therapy is unique in that it is one of the few Ayurvedic therapies which has been rigorously studied, evaluated and accepted by modern medicine. The Central Council for Research in Ayurveda and Siddha (CCRAS) and the Regional Research Laboratory, Jammu also conducted path breaking clinical research and contributed to the standardization of the procedure.

Ksharasutra therapy has become popular not only among Aurvedic surgeons but also among modern medicine surgeons because of its safety, cost-effectiveness, success rate and simplicity.  This therapy is now available in most Ayurvedic medical colleges in the country and also in some modern medicine hospitals.  Ksharasutra has also become popular in countries like Japan, Sri Lanka, Bangladesh and Nepal.  The scope for increasing the use of Ksharasutra in India is immense.  This is a procedure which should be made widely available at district and block level hospitals in the country.

One of the problems faces by patients using Ksharasutra is the mild to moderate pain experienced while the medicated thread is changed.  A great deal of research and clinical trials are going on to minimize the irritation caused by the medicated thread.  Ksharasutra prepared out of guggulu, honey, etc. appears to be a suitable alternative.

Source: PIB


Sharmaji is deeply involved with Ayurveda since 15 years. His interest and passion led him to launch and about a decade ago. Most of the Ayurveda news and articles on this site are approved or published by him.

9 thoughts on “National Workshop on Ksharasutra

  • August 26, 2007 at 10:52 pm

    i read article

  • September 10, 2007 at 9:49 pm

    i am also a ksharsutra prectitioner u may contact me on 09425084421

  • October 5, 2007 at 7:01 am

    This is very informative article on Ksharasutra therapy.
    I also work on this therapy.
    I really missed this workshop.

  • March 16, 2008 at 12:10 am

    I am the i
    1st Ph.D. on ksharasutra and treated over 10000 cases of anorectal disorders. I have attended the above said workshop at New Drelhi. I canbe contacted at the above email or on 929133655.

  • April 17, 2008 at 3:51 pm

    i am M.D in ksharasutra and introduced many new techniques in this field and can be contacted at above address and also at 09849666054

  • April 29, 2008 at 11:54 pm

    I got a vedio on the method of the ksharasutra application which I want to put here in this website. if any body is interested in it may please be seanding their request. to the email My recent case was a supra spinchteric fistual which I could sucessfullly treated with this method avoiding his proposed colostomy.

  • June 25, 2008 at 7:57 am

    Hello Drs .
    I used to produce the Kshara suthra thereads with Snuhi ksheera ,Apamarga kshara and Haridra choorn.

    My plan was an industrial production because that product was not available in the marcket.

    i was wondering if there is any such products available.

    Thank you

  • January 26, 2009 at 6:57 pm

    since 1990 ihave been practicing ksharasutra in anal fistula .i work at govt ayurveda college trivandrum and kannur .attended natinal workshop at Newdelhi.arund 2000 cases so far i had treated with ksharasutra.i^ d like to share my experiences
    thank you
    my e mail id drcrnnair@yahoo
    mob no 09447390126

  • August 14, 2010 at 11:38 am

    Apart from fistula treatment by K.S.,nowdays allsorts of piles and chronic anlfissure,and anal stricture and partial anal prolapse are successfully treated by K.S.with/without Kshar lotion/ointment without any adverse effect.Low cost effective with high oercent of success rate.Since 1981 my practice under ksharakarm procedurein force.Thank you.


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